Journal Information
Vol. 31. Issue 1.
Pages 1-6 (January - February 2020)
Share
Share
Download PDF
More article options
Visits
4
Vol. 31. Issue 1.
Pages 1-6 (January - February 2020)
Clinical Research
Neuromonitoring in the severe traumatic brain injury. Spanish Trauma ICU Registry (RETRAUCI)
Neuromonitorización en el traumatismo craneoencefálico grave. Datos del Registro español de Trauma en UCI (RETRAUCI)
Visits
4
Juan Antonio Llompart-Poua, Jesús Abelardo Barea-Mendozab, Marcelino Sánchez-Casadoc, Javier González-Robledod, Dolores María Mayor-Garcíae, Neus Montserrat-Ortizf, Pedro Enríquez-Giraudog, María Lourdes Cordero-Lorenzanah, Mario Chico-Fernándezb,
Corresponding author
murgchico@yahoo.es

Corresponding author.
, on behalf of the Neuro-intensive Medicine and Trauma Working Group of the SEMICYUC
a Servei de Medicina Intensiva, Hospital Universitari Son Espases, Institut de Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
b UCI de Trauma y Emergencias, Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, Spain
c Servicio de Medicina Intensiva, Hospital Virgen de la Salud, Toledo, Spain
d Servicio de Medicina Intensiva, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
e Servicio de Medicina Intensiva, Complejo Hospitalario de Torrecárdenas, Almería, Spain
f Servei de Medicina Intensiva, Hospital Universitari Arnau de Vilanova, Lleida, Spain
g Servicio de Medicina Intensiva, Hospital Universitario Río Hortega, Valladolid, Spain
h Servicio de Medicina Intensiva, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
This item has received
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Tables (2)
Table 1. Number of patients per participating site (n=1463).
Table 2. Use of neuromonitoring in patients with a GCS score ≤8 and in those who also had a head AIS score ≥3 points.
Show moreShow less
Abstract
Objective

To analyze the use of intracranial pressure (ICP) and cerebral oximetry monitoring in patients with severe traumatic brain injury (TBI) according to the Spanish Trauma ICU Registry (RETRAUCI).

Methods

We included TBI patients with Glasgow Coma Scale score ≤8. Hypotheses were tested using the Student-T or Wilcoxon tests (quantitative variables) and the Chi-square test (categorical variables). Multivariate analysis using logistic regression was performed to analyze the variables associated with the use of ICP monitoring.

Results

We analyzed 1463 patients. Age 49.1 years. Males 1130 (77.3%). Mechanism of injury: falls in 350 cases (23.9%). ISS 27.9. Uni- or bilateral mydriasis was present in 39.3% of the patients. Neurosurgical intervention within 24h was performed in 331 patients (22.7%). ICP was monitored in 635 patients (45.1%), pbtO2 in 122 patients (8.6%), SjVO2 in 19 patients (1.34%) and NIRS was used in 25 cases (1.77%). In the multivariate analysis, age, bilateral mydriasis at admission and previous use of antiplatelets or anticoagulants was inversely related with ICP monitoring. Severity of injury and the need of neurosurgical intervention increased the probability of ICP monitoring.

Conclusions

Our study shows a picture of ICP monitoring in severe TBI patients in our environment. Use of cerebral oximetry techniques is very limited.

Keywords:
Severe traumatic brain injury
Monitorization
Intracranial pressure
Brain tissue oxygenation
Resumen
Objetivos

Analizar el empleo de la monitorización de la presión intracraneal (PIC) y la oxigenación cerebral en los pacientes con traumatismo craneoencefálico (TCE) grave de acuerdo a los datos del Registro español de Trauma en las Unidades de Cuidados Intensivos (RETRAUCI).

Métodos

Se incluyeron los pacientes con TCE y una puntuación en la escala de coma de Glasgow ≤ 8 puntos. El contraste de hipótesis se realizó con el test de la t-Student o de Wilcoxon (variables cuantitativas) y el test de Chi-Cuadrado (variables categóricas). Se realizó un análisis multivariante mediante regresión logística para analizar las variables asociadas al empleo de monitorización de la PIC.

Resultados

Se analizaron 1463 pacientes. Edad 49,1 años, hombres 1130 (77,3%). Mecanismo lesional: caídas accidentales 350 casos (23,9%). ISS 27,9. Un 39,3% presentaron midriasis uni- o bilateral en la recogida. Cirugía craneal <24horas 331 pacientes (22,7%). La PIC se monitorizó en 635 pacientes (45,1%), la ptiO2 en 122 pacientes (8,6%), la SjO2 en 19 pacientes (1,34%) y se empleó el NIRS en 25 casos (1,77%). Tras el análisis multivariante, la edad, la midriasis bilateral al ingreso y la toma previa antiagregantes o anticoagulantes se asociaron negativamente con la probabilidad de monitorización de la PIC. La gravedad lesional y la necesidad de neurocirugía urgente aumentaron la probabilidad de monitorización.

Conclusiones

Nuestro trabajo muestra una foto fija de la monitorización de la PIC en el TCE grave en nuestro medio. El empleo de técnicas de oximetría cerebral en nuestro país es muy limitado.

Palabras clave:
Traumatismo craneoencefálico grave
Monitorización
Presión intracraneal
Presión tisular de oxígeno

Article

These are the options to access the full texts of the publication Neurocirugía (English edition)
Member
Member of the Sociedad Española de Neurocirugía

If it is the first time you have accessed you can obtain your credentials by contacting Elsevier Spain in suscripciones@elsevier.com or by calling our Customer Service at902 88 87 40 if you are calling from Spain or at +34 932 418 800 (from 9 to 18h., GMT + 1) if you are calling outside of Spain.

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option ¿I have forgotten my password¿.

Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Neurocirugía (English edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
Neurocirugía (English edition)
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?